Medical Director
Company: Molina Healthcare
Location: Long Beach
Posted on: January 12, 2021
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Job Description:
Job Description Job Summary Responsible for serving as the
primary liaison between administration and medical staff. Assures
the ongoing development and implementation of policies and
procedures that guide and support the provision of medical staff
services. Maintains a working knowledge of applicable national,
state and local laws and regulatory requirements affecting the
medical and allied health staff. Knowledge/Skills/Abilities *
Facilitates conformance to regulatory requirements.* Reviews
quality referred issues, focused reviews and recommends corrective
actions.* Monitors appropriate care and services through continuum
among hospitals, skilled nursing facilities and home care to ensure
quality, cost-efficiency and continuity of care.* Develops and
implements medical policies.* Conducts retrospective reviews of
claims and appeals, and resolves grievances related to medical
quality of care.Job roles and responsibilities emphasize a
team-based approach to care and support each member of the team
being trained to meet the highest level of function allowed by
state law. Job Qualifications Required Education * Doctorate Degree
in Medicine* Board Certified or eligible in a primary care
specialtyRequired Experience * 7-9 years relevant experience,
including:* 5+ years clinical practice* 2 years previous experience
as a Medical Director* 3 years experience in Utilization/Quality
Program management* 2+ years HMO/Managed Care experience* Current
clinical knowledge* Experience demonstrating strong management and
communication skills, consensus building and collaborative ability,
and financial acumen* Knowledge of applicable state, federal and
third party regulationsRequired License, Certification, Association
* Current state Medical license without restrictions to practice
and free of sanctions from Medicaid or Medicare.Preferred Education
Master's in Business Administration, Public Health, Healthcare
Administration, etc. Preferred Experience * 10+ years relevant
experience* Peer Review, medical policy/procedure development,
provider contracting experience.To all current Molina employees: If
you are interested in applying for this position, please apply
through the intranet job listing. Molina Healthcare offers a
competitive benefits and compensation package. Molina Healthcare is
an Equal Opportunity Employer (EOE) M/F/D/V.
Keywords: Molina Healthcare, Long Beach , Medical Director, Executive , Long Beach, California
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